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American Cancer Society Guidelines for

the Early Detection of Cancer
● Breast cancer
● Colon and rectal cancer and polyps
● Cervical cancer
● Endometrial cancer
● Lung cancer
● Prostate cancer
● Take control of your health, and help reduce your cancer risk.

Screening tests are used to find cancer before a person has any symptoms. Screening
can often help find and treat pre-cancers and cancers early, before they have a chance
to spread.

Here are the American Cancer Society's recommendations to help guide you when you
talk to your doctor about screening for certain cancers.

Breast cancer

● Women ages 40 to 44 should have the choice to start annual breast cancer
screening with mammograms (x-rays of the breast) if they wish to do so.
● Women age 45 to 54 should get mammograms every year.
● Women 55 and older should switch to mammograms every 2 years, or can
continue yearly screening.
● Screening should continue as long as a woman is in good health and is expected to
live 10 more years or longer.
● All women should be familiar with the known benefits, limitations, and potential

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harms linked to breast cancer screening.

Women should also know how their breasts normally look and feel and report any
breast changes to a health care provider right away.

Some women – because of their family history, a genetic tendency, or certain other
factors – should be screened with MRIs along with mammograms. (The number of
women who fall into this category is very small.) Talk with a health care provider about
your risk for breast cancer and the best screening plan for you.1

Colon and rectal cancer and polyps

For people at average risk for colorectal cancer2, the American Cancer Society
recommends starting regular screening at age 45. This can be done either with a
sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or
with an exam that looks at the colon and rectum (a visual exam). Talk to your health
care provider about which tests might be good options for you, and to your insurance
provider about your coverage. No matter which test you choose, the most important
thing is to get screened.

If you’re in good health, you should continue regular screening through age 75.

For people ages 76 through 85, talk with your health care provider about whether
continuing to get screened is right for you. When deciding, take into account your own
preferences, overall health, and past screening history.

People over 85 should no longer get colorectal cancer screening.

If you choose to be screened with a test other than colonoscopy, any abnormal test
result needs to be followed up with a colonoscopy.

Cervical cancer

● Cervical cancer screening3should start at age 25. People under age 25 should not
be tested because cervical cancer is rare in this age group.
● People between the ages of 25 and 65 should get a primary HPV (human
papillomavirus) test* done every 5 years. If a primary HPV test is not available, a
co-test (an HPV test with a Pap test) every 5 years or a Pap test every 3 years are
still good options.

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(*A primary HPV test is an HPV test that is done by itself for screening. The US Food
and Drug Administration has approved certain tests to be primary HPV tests.)

The most important thing to remember is to get screened regularly, no matter

which test you get.

● People over age 65 who have had regular cervical cancer testing in the past 10
years with normal results should not be tested for cervical cancer. Once testing is
stopped, it should not be started again. Those with a history of a serious cervical
pre-cancer should continue to be tested for at least 25 years after that diagnosis,
even if testing goes past age 65.
● People whose cervix has been removed by surgery for reasons not related to
cervical cancer or serious pre-cancer should not be tested.
● People who have been vaccinated against HPV should still follow the screening
recommendations for their age groups.

Some individuals – because of their health history (HIV infection, organ transplant, DES
exposure, etc.) – may need a different screening schedule for cervical cancer. Talk to a
health care provider about your history.

Endometrial cancer

The American Cancer Society recommends that at the time of menopause, all women
should be told about the risks and symptoms of endometrial cancer4. Women should
report any unexpected vaginal bleeding or spotting to their doctors.

Some women – because of their history – may need to consider having a yearly
endometrial biopsy. Please talk with a health care provider about your history.

Lung cancer

The American Cancer Society recommends yearly screening for lung cancer with a low-
dose CT (LDCT) scan5 for people ages 50 to 80 who:

● Smoke or used to smoke

AND

● Have at least a 20 pack-year history of smoking

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A pack-year is equal to smoking 1 pack (or about 20 cigarettes) per day for a year. For
example, a person could have a 20 pack-year history by smoking 1 pack a day for 20
years, or by smoking 2 packs a day for 10 years.

Before deciding to be screened, people should have a discussion with a healthcare

professional about the purpose of screening and how it is done, as well as the benefits,
limits, and possible harms of screening.

People who still smoke should be counseled about quitting and offered interventions
and resources to help them.

People should not be screened if they have serious health problems that will likely limit
how long they will live, or if they won’t be able to or won’t want to get treatment if lung
cancer is found.

Prostate cancer

The American Cancer Society recommends that men make an informed decision with a
health care provider about whether to be tested for prostate cancer6.

Starting at age 50, men should talk to a health care provider about the pros and cons of
testing so they can decide if testing is the right choice for them.

If you are African American or have a father or brother who had prostate cancer before
age 65, you should have this talk with a health care provider starting at age 45.

If you decide to be tested, you should get a PSA blood test with or without a rectal
exam. How often you’re tested will depend on your PSA level.

Take control of your health, and help reduce your cancer risk.

● Stay away from all forms of tobacco.

● Get to and stay at a healthy weight.
● Get moving with regular physical activity.
● Eat healthy with plenty of fruits and vegetables.
● It's best not to drink alcohol. If you do drink, have no more than 1 drink per day for
women or 2 per day for men.
● Protect your skin.
● Know yourself, your family history, and your risks.

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● Get regular check-ups and cancer screening tests.

Hyperlinks

1. www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-
detection/american-cancer-society-recommendations-for-the-early-detection-of-
breast-cancer.html
2. www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/acs-
recommendations.html
3. www.cancer.org/cancer/types/cervical-cancer/detection-diagnosis-staging/cervical-
cancer-screening-guidelines.html
4. www.cancer.org/cancer/types/endometrial-cancer/detection-diagnosis-
staging/detection.html
5. www.cancer.org/cancer/types/lung-cancer/detection-diagnosis-
staging/detection.html
6. www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/acs-
recommendations.html

References

Fontham ETH, Wolf AMD, Church TR, et al. Cervical cancer screening for individuals at
average risk: 2020 guideline update from the American Cancer Society. CA Cancer J
Clin. 2020. https://doi.org/10.3322/caac.21628.

Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2018: A
review of current American Cancer Society guidelines and current issues in cancer
screening. CA Cancer J Clin. 2019 May;69(3):184-210. doi: 10.3322/caac.21557.

Wolf AMD, Oeffinger KC, Shih YCT, et al. Screening for lung cancer: 2023 guideline
update from the American Cancer Society. CA Cancer J Clin. 2023.
doi:10.3322/caac.21811.

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Last Revised: November 1, 2023

Written by

The American Cancer Society medical and editorial content team

(https://www.cancer.org/cancer/acs-medical-content-and-news-staff.html)

Our team is made up of doctors and oncology certified nurses with deep knowledge of
cancer care as well as journalists, editors, and translators with extensive experience in
medical writing.
American Cancer Society medical information is copyrighted material. For reprint
requests, please see our Content Usage Policy (www.cancer.org/about-
us/policies/content-usage.html).

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